Quick Overview

ZABBYS SILICONE PERFORATED EYE SPHERE 18MM ZEP18

Double click on above image to view full picture

More Views

Details

ZABBYS SILICONE PERFORATED EYE SPHERE 18MM ZEP18

INTRODUCTION

In Patient, in whom the enucleation has been done,there is no mobile base to fix prosthesis. The purpose of perforated silicone eye sphere is to maintain contour of eyeball, maintain the eye movements,provide a base for prosthesis, and maintain shape of eye socket and to prevent bony deformity. Lastly, but not the least, to give full self-confidence to the patient. It gives excellent cosmetic results. The artificial eye prosthesis, to be worn later on, will look natural due to good eye contour and almost full eye movements.

DESCRIPTION & PRESENTATION

The perforated eye sphere is made of medical grade silicone elastomer. It is molded in one piece. The perforated eye sphere is available in four sizes. Supplied sterilized by Ethylene Oxide and in double peel open packs

Size Code No. Size Code No.

14 mm ZEP14 16 mm ZEP16

18 mm ZEP18 20mm ZEP20

INDICATIONS

Perforated eye sphere is indicated in all cases where enucleation is done and good cosmetic results are desirable.

CONTRAINDICATION

Like all implants, it is contraindicated in cases where active infection or inflammation is present. Preferably it should be inserted after six months to one year of subsidence of inflammation.

PRECAUTION

Prior to surgery, prospective patients and or their representative should be informed of the possible complications associated with the use of this product.

OPERATIVE PROCEDURE

The implantation of silicone eye sphere may be choice depends upon the training of surgeon, customs in that hospital, country. Therefore the surgeon is best advised to use method, which his/her own practice and training dictate to be best for the patient. Following procedure is to act as guideline only. Enucleation of eyeball is done on standard lines. Before division of rectus muscles retention sutures are applied as follows.

A double armed suture of 1.5 metric (5/0) chromic catgut is passed through the muscle 3 mm behind its insertion and transversely to the long axis of the fibers as a stitch through one edge, a mattress in the center of the muscle and a stitch at the other edge. This suture is held in pressure forceps and lifted so that the muscle is raised from the sclera to allow passage of one blade of the strabismus scissors beneath the muscle. The muscle is then divided 1 mm behind its insertion. Same procedure is performed with all muscles. After removal of the eye ball and complete hemostasis a proper size of perforated eye sphere is selected. It should be smaller than the original eyeball. The pack is removed from Tenon's capsule and cavity sprayed with an antibiotic. One of the retention sutures is passed through the hole in the eye sphere. The suture is inserted from the round end and so that it emerges through the depressed flat end of eye sphere. The idea is to keep the round side of eye sphere posteriorly and flat side anteriorly. The retention sutures of other three recti muscles are passed in similar fashion through the holes in perforated eye sphere. The sequence of rectus muscles is maintained i.e. 3 o clock muscle suture is passed through 3 o clock hole. In a similar fashion 6 o clock muscle suture is passed through 6 o clock hole. In this fashion all four retention sutures are passed through holes. Now the sphere is pushed into Tenon's capsule and ends of all four muscles are drawn out through the holes. The inferior rectus is first laid into the central depression of the sphere, where it is overlapped for about 5 mm by superior rectus. The suture in the inferior rectus passes through the deep surface of the superior rectus about 4 mm behind its free end and is tied by surgical knot on the surface of the superior rectus muscle. The suture in the superior rectus muscle transfixes the edges of the inferior rectus in the form of a stitch and is then carried transversely across the united muscles to be tied by a surgical knot. A similar procedure is adopted with the other two muscles. To make it more secure, adjacent muscles are also stitched together. The free end of the superior oblique is stretched to the medial edge of superior rectus and the free end of the inferior oblique muscle is sutured to the lower margin of the lateral rectus at the equator of sphere. The closure is performed on standard lines. Adequate pressure bandage is applied.

POST OPERATIVE MANAGEMENT

The patient may be mobilized early. On the first postoperative day the conjunctival sac is irrigated. The firm pressure dressing is maintained for 2 days,when the socket is dressed. This may be re applied with daily dressings until the fifth day. An acrylic shell may be placed in the conjunctival sac and a convex black eye shade, lined with sheet of lint, the smooth side opposed to the socket, is applied. The acrylic shell, approximately the shape and size of prostheses to be fitted later, helps to reduce the edema of the conjunctiva and to maintain the appropriate size and shape of the socket. A prosthesis is fitted in the third or fourth week of operation. Pain may be severe for two three days and chemosis may take up to three weeks to subside.

COMPLICATIONS

Complications which may result from the use of this product include the risks associated with the medication and methods utilized in the surgical procedure, as well as patients response, reaction or degree of intolerance to any foreign object implanted into the body. The medical literature is full of hazards and complications associated with use of silicone eye spheres. It is implied & understood that since user is highly trained super-specialist. He has experience of silicone eye spheres implantation. He is fully aware of all the hazards associated with use of silicone eye spheres and he has studied the medical literature well before use.

The main complications of use of an eye sphere are infection and expulsion. To prevent infection, use of implant should be avoided with active inflammation. Suitable antibiotic cover should be given during and after implantation.